Nursing Care of patient Ischemic Stroke : Case Study

การพยาบาลผู้ป่วยโรคหลอดเลือดสมองตีบและอุดตัน: กรณีศึกษา

Abstract

Cerebrovascular disease or Stroke is the second leading cause of death in the world and Thailand. Survivors have physical, mental, and social consequences such as disability, a burden on the family, loss of economic productivity. The cause is ischemic stroker is urgently treatment accessing and will be given by injecting recombinant tissue plasminogen activator (rt-PA) within 4.5 hours, so rapid delivery is an important factor in minimizing this effect. Stroke is the number 1 emergency disease among emergency and forensic accident department of Non Thai Hospital and number one in referrals to Maharat Nakhon Ratchasima Hospital. In between 2019 and 2023 had 172, 154,119, 135 and 139 cases, respectively, the coming by the Emergency Medical service (EMS) system within the response period within 8 minutes was 76.74%, 76.74%, 62.5%, 73.91% and 75.86% respectively. The study selected 1 stroke patient who was ischemic stroke and study in January to March 2021, the educational objective aimed to encourage stroke patients to receive quality and efficient services in the Stroke fast tract system. To improve the EMS response in time system, a case study of a 63-year-old Thai female patient who came for treatment on January 29, 2021 by the EMS service system with symptoms of weakness in her right and lower extremities, walking staggering, not speaking clearly, sent for treatment at the hospital. Great Brain radiograph There were no white patches or radiographs that were darker than normal. Received back for treatment in the hospital on January 30, 2021. The problem found was high blood pressure. high blood sugar levels, low potassium level also the right limb was weakness. She worried about getting sick. The doctor treated her with fluids, antiplatelet drugs, physical therapy, massage, compress, and provide nursing care. Consult a psychologist and nutritionist, morale boosting Results that physical, mental, and emotional disorders were gradually improve. The patient cooperates in the treatment plan as recommended by the multidisciplinary team. After providing nursing care, the patient's symptoms improved, shock none occurred, high blood sugar cured, none both of nausea and vomiting, no contractions, fatigue improved, and all looked good. High blood pressure was cured and slowdown into 130/70 -150/80 mmHg, Barthel Index increased. She stayed for 5 days of treatment and discharged. For caring acute stroke patients before the patient arrives at the hospital is important, also quickly symptom detection and access to a fast EMS service system and a quality service system would respond to reduce the impact on patients. Therefore, it should be used to adjust the service system to cover more all patients in the next period.